| Veteran's Administration | |
|
3035 E Mound Rd Decatur IL 62526-9650 | |
| (217) 875-2670 | |
| (217) 875-2689 |
| Full Name | Veteran's Administration |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3035 E Mound Rd, Decatur, Illinois |
| Authorized Official Name and Position | Geraldine Thornhill Wirth (NURSE PRACTITIONER) |
| Authorized Official Contact | 2178752670 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Veteran's Administration 632 E Bodman St Bement IL 61813-1206 Ph: (217) 620-8891 | Veteran's Administration 3035 E Mound Rd Decatur IL 62526-9650 Ph: (217) 875-2670 |
| NPI Number | 1043323793 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043323793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Illinois) | Primary |
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